الفهرس 
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Abstract
The target of this study is to evaluate the use of custom made polyetheretherketone (PEEK) plate in the fixation of mandibular fracture.
Twelve patients with mandibular fracture have been selected from the Emergency Ward of Alexandria University Teaching Hospital and will be operated upon in the Oral and Maxillofacial Surgery Department, Faculty of Dentistry, Alexandria University.
All the selected subjects were of age (20-43) with no gender predilection suffering from recent, uninfected, non-comminuted, Unfavorable fracture demanding open reduction and internal fixation of mandibular fracture. Excluding those with systemic diseases that could have interfered with healing.
A detailed history taking and a thorough clinical examination and radiographic examination was performed and recorded for every patient.
6.1.1 Surgical procedure
2D section images were used to define the image thresholds so as to eliminate all of the soft tissue and only highlighting bone and dental tissues, 3D reconstruction of the segmented mandible along with dental hard tissue was created, the reconstructed mandible was further segmented into individual fracture segments. The fracture was virtually reduced anatomically and the PEEK plates were then planned and milled.
Custom-made PEEK plates were designed using CAD/CAM before surgery as mentioned before. During the operation, occlusion was secured with temporary IMF, the fracture line is exposed and manually reduced, the custom-made plates were placed in position and secured with titanium screws. The incision is then closed with sutures (3/0 Vicryl).
Clinical evaluation for pain (assessed by visual analogue scale), state of occlusion, mouth opening (assessed by measuring inter-incisal distance in mm), sensory nerve function, infection and wound healing was performed for 6 postoperative months.
All the cases experienced a statistically significant decrease in level of pain intensity score based on the Visual Analogue Scale (VAS) across the follow up period. The occlusal examination showed a normal occlusal and intercuspal relation in all of the cases. Two cases showed sensory impairment in the lower lip, both regained normal sensation by the end of the follow up period. None of the patients developed infection.
A postoperative radiographic appraisal was performed using an immediate postoperative CT-scan and another after three months and six months for radiodensitometric estimate of the mean bone density. All the cases demonstrated a statistically significant increase in the calculated mean bone density across the follow up period.